BREAST FEEDING PRACTICES BREAST FEEDING PRACTICES IN SLUMS UNDER IN SLUMS UNDER

GUWAHATI MUNICIPAL GUWAHATI MUNICIPAL CORPORATIONCORPORATION

Prof.J.N. SharmaProf.J.N. Sharma

Dhrubajyoti Sharma* Dhrubajyoti Sharma*

Dept. Of PaediatricsDept. Of Paediatrics

Gauhati Medical collegeGauhati Medical college

TRADITIONAL

INTRODUCTIONINTRODUCTION

• Breast feeding practices include Breast feeding practices include exclusive breast feeding for 6 exclusive breast feeding for 6 months and extended breast feeding months and extended breast feeding up to 2 years or beyond.up to 2 years or beyond.

• There are many traditional practices There are many traditional practices associated with breast feeding of associated with breast feeding of which certain undesirable practices which certain undesirable practices need to be discouraged.need to be discouraged.

MATERIALS AND METHODMATERIALS AND METHOD• Study was conducted in 15 slums under GMC among Study was conducted in 15 slums under GMC among

300 mothers who had children from 6 months to 24 300 mothers who had children from 6 months to 24 months age.months age.

• Few mothers with children up to 25 to27 months were Few mothers with children up to 25 to27 months were also included in the present study as per the need.also included in the present study as per the need.

• Institution:Institution:dept. of Paediatrics Gauhati Medical College.dept. of Paediatrics Gauhati Medical College.• Period of study:Period of study:from 1from 1stst March 2005 to 31 March 2005 to 31stst August August

2005.2005.• Data were collected in pretested proforma using Data were collected in pretested proforma using

structured questionnaire. structured questionnaire. • Prevailing breast feeding practices, beliefs and factors Prevailing breast feeding practices, beliefs and factors

associated with it were noted.associated with it were noted.

RESULTS AND OBSERVATIONSRESULTS AND OBSERVATIONS

7.33%15.60%12.30%

22.66%

42%

0%

10%

20%

30%

40%

50%

within 1hr

1-4 hr 1-2 days 2-3 days 3-4 days

INITIATION OF BREAST FEEDING

42% initiated within one hour.

Time since birth at initiation

(n=300)

12.12%

36.36%

9.87%12.34%14.81%

59.25%

3.70%

18.93%9.84%

22.72%

66.66%

33.33%

0.00%

20.00%

40.00%

60.00%

80.00%

w ithin 1 hr 1to4hr 1to2days 2to3ays 3to4days

Hindu

Muslim

Sikh

HISTOGRAM SHOWING TIME AT INITIATION IN

3 RELIGIONS IN THE PRESENT STUDY

59.25% Hindu initiated within 1 hr.22.72% Muslim initiated within 1hr.Sikhs initiated after second day.

(n=162)

(n=132)

(n=6)

Time since birth at initiation of Breast feeding

Initiation of Breast feeding within 1hr.

42

84

5769

0102030405060708090

Initiation of Breastfeeding within 1hr.

according to place of delivery and literate-illiterate

84(68.29%)hospital deliveries initiated within 1hr. in contrast with 42(23.72%)home deliveries.(p value<.05)

69(57.02%)literate initiated within 1 hr. in contrast with 57(31.84%)illiterate.(p value<.05)

46%

10%8%

11%

12%

7% 6% Doctor

Nurse

Neighbour

Experinced

Radio and/orTV

Mother-in-low

No sourse

Source of information for initiation within 1hr.

46% received information from Doctor.12% from Radio/TV and 10% received information from Nurse.

11%know themselves that breast feeding should be initiated within 1hr (experienced).

6%traditionally initiated within 1 hr (no source).

56.67%

43.33%Prelacteals given

Prelactealsnotgiven

INTRODUCTION OF PRELACTEALS

56.67% introduced prelacteals.

69

95

6

93

37

0102030405060708090

100

Prelacteals given

Prelacteals notgiven

42.59% Hindu,71.97% Muslim introduced prelacteals and

100% Sikh introduced prelacteals.

INTRODUCTION OF PRELACTEALS IN 3 RELIGIONS

160

10

124

46

17

113

55

75

0

20

40

60

80

100

120

140

160

Prelacteals given Prelacteals not given

Home(n=177)

Hospital(n=123)

Illiterate(n=179)

Literate(n=121)

INTRODUCTION OF PRELACTEALS ACCORDING TO PLACE OF DELIVERY AND LITERATE-ILLITERATE

90.39% home deliveries and 8.13% hospital deliveries introduced prelacteals(p value<.05).

69.27%illiterate and 38.01%literate introduced prelacteals(p value<.05).

54%

46% Feeding colostrumwithin 4 hr.

Not feeding colostrumwithin 4hr.

COLOSTRUM FEEDING WITHIN

4 HRS. OF BIRTH

54% fed colostrums within 4 hrs. of birth.

(n=300)

feeding colostrum within 4 hrs. of birth

120

43

00

20406080

100120140

feedingcolostrum within4 hrs. of birth

COLOSTRUM FEEDING WITHIN 4 HRS. IN 3 RELIGIONS

74.07% Hindu and 32.57% Muslim fed colostrums within 4 hrs of birth.

Sikh did not feed colostrums within 4 hrs of birth.

42

121

7093

135

2

109

28

020406080

100120140160

colostrum feedingwithin 4 hrs ofbirth

98.37% hospital deliveries and 23.72% home deliveries fed colostrums within 4 hrs of birth(p value <.05).

76.85% literate and 39.1% illiterate fed colostrums within 4 hrs of birth(p value<.05).

PLACE OF DELIVERY LITERATE-ILLITERATE IN

COLOSTRUM FEEDING WITHIN 4 HRS.

40.87%

13.13%19.70%

10.94%

5.83%

9.48%

Milk is not present in thebreasts during 1to3 daysafter deliveryColostrum is harmful for rhebaby

No reason

Panditji advised

Neighbour advised

Mother-in-low advised

REASONS AND BELIEFS FOR NOT FEEDING COLOSTRUMS

40.87% believed that milk is not present in the breast during 1to3 days after birth .

13.13% not fed because colostrum is harmful for the baby.

In 10.94% Panditji advised.

No of cases(n=300)

2345

110104

180

20406080

100120

No ofcases(n=300)

Duration of Exclusive Breast Feeding

EXCLUSIVE BREAST FEEDING

34.67% practiced EBF for 6 months.

36.67% practiced EBF for 7to9 months.

8% for 2-3 months and 6% continued up to 10-12 months.

EBF for 6 months

25

18

1312

6

21

0

5

10

15

20

25

30

Assamesespeaking

Hindu

Assamesespeakingmuslim

BengalispeakingMuslim

Bihari Harijan Bengalispeaking

Hindu

EBF for 6 months

(n=49) (n=82) (n=50) (n=41) (n=43) (n=13)

51.02%Assamese speaking Hindu.

21% in Assamese speaking Muslim.

24% in Bengali speaking Muslim.

EBF FOR 6 MONTHS IN SOME MAJOR COMMUNITIES

29

75

40

64

0

10

20

30

40

50

60

70

80

EBF for 6 months

Home (n=177)

Hospital(n=123)

Illiterate(n=179)

Literate(n=121)

PLACE OF DELIVERY AND LITERATE-ILLITERATE IN EBF FOR 6 MONTHS

66.67% hospital and 16.38% home deliveries practiced EBF

for 6 months(p value<.05).52.89% literate and 22.34% illiterate

Practiced EBF for 6 months(p value<.05).

60%7%

14%

3%

1% 9% 6% Doctor

Nurse

Experienced

Neighbour

Mother-in-low

Radio and/or TV

No source

SOURCE OF INFORMATION FOR EBF FOR 6 MONTHS

60% received information from Doctors.14% know themselves(experienced).

6% traditionally practiced EBF for 6 months(no source).

CONTINUED BREAST FEEDING UPTO OR BEYOND 2 YEARS

98% continued up to or beyond 2 years.

N=82.

Continued Breast feeding up to or beyond 2 years(n=82)

98%

2%

Yes

No

78%

10%3% 9%

No source

Doctor

Mother-in-low

Experienced

SOURCE OF INFORMATION FOR CONTINUED BREAST FEEDING UP TO OR BEYOND 2 YEARS

78% continued for traditional reason(no source).

CONCLUSIONCONCLUSION• Undesirable traditional practices such Undesirable traditional practices such

as- giving prelacteals,late initiation as- giving prelacteals,late initiation of Breast feeding are still prevalent of Breast feeding are still prevalent among the mothers and more so among the mothers and more so among illiterates and home deliveries. among illiterates and home deliveries.

• Doctor’s advice, hospital delivery and Doctor’s advice, hospital delivery and literacy may play an important role in literacy may play an important role in discouraging such potentially harmful discouraging such potentially harmful practices.practices.

• Prevalence of EBF for 6 months is low.Prevalence of EBF for 6 months is low.• Extended Breast feeding is Extended Breast feeding is

encouragingencouraging. .

..